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Full text of "Medical Jurisprudence And Toxicology"

534                                              MEDICAL JURISPRUDENCE

spasm of the glottis soon after she had swallowed a strong solution of copper
sulphate.79 A young lady80 died about an hour after the onset of symptoms
of poisoning. On analysis copper sulphate equivalent to 38 grains and
methylene blue were detected in the stomach and its contents. A Maho-
metan female,81 24 years old, died within 2 to 2£ hours after she had taken
copper sulphate with intent to commit suicide.

Treatment.—There is no need to use emetics, as vomiting occurs in five
or ten minutes after taking the poison. Wash out the stomach with water
containing potassium ferrocyanide, which forms insoluble cupric ferro-
cyanide. Administer white of egg or milk as an antidote. The albumen
contained in them will form an insoluble salt, albuminate of copper. Give
demulcent drinks. Relieve pain by injecting morphine hydrochloride
hypodermically, and use diuretics if the urine is suppressed. Give castor oil
to remove the poison from the intestines. Support the patient by giving
nutrient enemata, and by using stimulants hypodermically.

Post-mortem Appearances.—The skin may be yellow owing to jaundice.
The mucous membrane of the alimentary canal may be congested, swollen,
inflamed and excoriated. The contents of the stomach are green or blue,
and so is the colour of its mucous membrane. The mucous membrane of the
duodenum may present the same appearance. The colon sometimes shows
large ulcerations, and the rectum may be perforated. The liver may be soft
and fatty. The kidneys may show the signs of parenchymatous inflammation.

Chronic Poisoning.—This may occur among workers in copper and its
salts or its alloys owing to the inhalation of copper dust. It may also occur
from food being contaminated with verdigris obtained from dirty copper
vessels.

Symptoms.—These are a green or purple line on the gums, a constant
coppery taste in the mouth, giddiness, headache, dyspepsia, vomiting,
diarrhoea with colicky pain, laryngitis, bronchitis, ansemia, peripheral
neuritis and atrophy of the muscles.

i       The skin becomes jaundiced; the hair, urine and perspiration become
green.

Mallory82 of Boston points out that chronic copper poisoning causes the
symptom-complex known, under the different names, as haemochromatosis,
bronzed diabetes and pigment cirrhosis.

Treatment.—Remove the cause, and use massage and warm baths. Keep
the patient in fresh air, and attend to his diet and dyspepsia, Copper vessels
used for cooking purposes should be tinned, and kept scrupulously clean*

Post-mortem Appearances.—The chief post-mortem appearances are
fatty degeneration of the liver and degeneration of the epithelial cells of the
kidneys.

Chemical Tests.—1. Hydrochloric acid and hydrogen sulphide give a
brownish-black precipitate, insoluble in. ammonium sulphide, but soluble in
potassium cyanide, and freely soluble in warm nitric acid.

2.    Ammonium hydroxide gives a greenish-blue precipitate, soluble in
excess forming a blue solution.

3.    A few drops of potassium ferrocyanide solution added to a neutral
or faintly acid solution of a copper salt produces a reddish-brown precipitate
of cupric ferrocyanide, soluble in warm dilute nitric acid.

'79.   Wachhoiz Ztchr, j. Med. Beamte, 1893, VI, p. 397; Witthaus, Manual of Toxicology,
Ed'. IT, p, 708.
SO.-  U.B.-Chemieal Examiner's Annual Report, 1930, p. 5.

81.   Bengal Chemical Examiner's Annual Report, 1931, p. 7.

82.   Archives of Internal Medicine,, Chicago, March 15,* 1926, p. 336.